Anatomic and isometric points on femoral attachment site of popliteus muscle-tendon complex for the posterolateral corner reconstruction

Jae Hyuk Yang, Hong Chul Lim, Ji Hoon Bae, Harry Fernandez, Tae Soo Bae, Joon Ho Wang

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    Study design: Descriptive laboratory study. Purpose: The femoral anatomic insertion site and the optimal isometric point of popliteus tendon for posterolateral reconstruction are not well known. Purpose of this study was to determine the relative relationship between the femoral anatomic insertion and isometric point of popliteus muscle-tendon complex with the lateral epicondyle of femur. Methods: Thirty unpaired cadaveric knees were dissected to determine the anatomic femoral insertion of the popliteus tendon. The distance and the angle from the lateral epicondyle of femur to the center of the anatomic insertion of the popliteus tendon were measured using digital caliper and goniometer. Eight unpaired fresh cadaveric knees were examined to determine the optimal isometric point of femoral insertion of popliteus tendon using computer-controlled motion capture analysis system (Motion Analysis, CA, USA). Distances from targeted tibial tunnel for popliteus tendon reconstruction to the 35 points gained on the lateral surface of femur were recorded at 0, 30, 60, 90, and 120° knee flexion. A point with the least excursion (<2.0 mm) was determined as the isometric point. Results: The center of anatomic insertion points and the optimal isometric point for the main fibers of popliteus tendon were found to be posterior and distal to the lateral epicondyle of femur. The distance from the lateral epicondyle of femur to the center of anatomic femoral insertion of popliteus tendon was 11.3 ± 1.2 mm (mean ± SD). The angle between long axis of femur and the line from lateral epicondyle of femur to anatomic femoral insertion of popliteus tendon was 31.4 ± 5.3°. The isometric points for the femoral insertion of popliteus muscle-tendon complex were situated posterior and distal to the lateral epicondyle in all 8 knees. The distance between the least excursion point and the lateral epicondyle was calculated as 10.4 ± 1.7 mm. The angle between the long axis of femur and the line from lateral epicondyle of femur to optimum isometric point of popliteus tendon was calculated as 41.3 ± 14.9°. Conclusion: The optimal isometric point for the femoral insertion of popliteus muscle-tendon complex is situated posterior and distal to the lateral epicondyle of femur. Femoral tunnel for "posterolateral corner sling procedure" should be placed at this point to achieve least amount of graft excursion during knee motion.

    Original languageEnglish
    Pages (from-to)1669-1674
    Number of pages6
    JournalKnee Surgery, Sports Traumatology, Arthroscopy
    Volume19
    Issue number10
    DOIs
    Publication statusPublished - 2011 Oct

    Keywords

    • Anatomic femoral insertion
    • Isometric point
    • Popliteus muscle-tendon complex
    • Posterolateral corner sling

    ASJC Scopus subject areas

    • Surgery
    • Orthopedics and Sports Medicine

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